Kenneth L Crutcher, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MMD33307 Issued in SC

Practice address

4303 Live Oak Dr
Little River, SC 29566-9138

Phone

(843) 663-8000

Fax

(843) 280-2455

NPI assigned

Mar 28, 2006

Last updated

Sep 23, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Caldwell Emergency Medical Associates LLC

  • Emergency Medicine Physician
  • Lenoir, NC
  • NPI 1023074580
  NPD (past)
• Sterling Emergency Services of the Southeast, Inc

  • Emergency Medicine Physician
  • Salisbury, NC
  • NPI 1770541245
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1063473320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4303 LIVE OAK DR",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295669138",
            "telephone_number": "843-663-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4303 LIVE OAK DR",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295669138",
            "telephone_number": "843-663-8000",
            "fax_number": "843-280-2455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUTCHER",
        "first_name": "KENNETH",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "29550",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "MMD33307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8926422",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "26422",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Creating Meaning Counseling Services LLC
• Lyndsi Cress, D.O.
• Susan Kaye Crisp, LPC
• Christopher Crown
• Elizabeth Stamey Crutcher, BSN, RN
• Kathleen May Curran Shields, RN
• Amanda Dorsey Cutshaw, FNP-C
• CVS Pharmacy
• Meredith Dammers, FNP
• Deborah Sailor Daniels, LMT

• Family Medicine Physician in Little River, SC
• Providers in Little River, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.